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Pressurize Your Anatomical Inner Tube

Push Up Position Planks

The center of the body is a cylindrical tube of interwoven muscle and fascia.  On the top and bottom, you have the diaphragm and pelvic floor.  The sides are reinforced by the oblique muscles and across the front by the rectus and tranverse abdominus muscles.  These muscles work together to create pressure inside the cylinder.  The tension capacity of our “anatomical inner tube” allows us to lift, carry, push, and pull loads that would overwhelm any single joint in the spine.  Developing better tension strength will improve athleticism and reduce injuries.  One of the best exercises to improve tension strength is the Push Up Position Plank.

Push Up Position Planks – PUPP

Place the hands under the shoulders with the elbows extended.  Pull your shoulder blades down your back and keep your neck long.  Lift your pelvis so that your body is supported on the feet and hands.  Pull the legs together and lift up onto the balls of the feet.  Your body is held in one long line from the ears to the ankles.  Do not let your hips sink or rise up—check your position in a mirror.  Create an isometric external rotation force in the shoulders by screwing the hands into the floor.  Imagine you are crushing oranges in your armpits.  Now squeeze the legs together and pull the hands toward the toes.  Hold that position for twenty seconds and work up to longer durations.  A good goal is a thirty-second high tension PUPP.

Elevated Feet-Push Up Position Plank

Once you can hold a solid thirty second push up position plank with the feet on the floor, progress to elevating the feet on a step or exercise bench for more resistance.  Work up to a thirty-second hold.

In rehab, we use push up position planks to help patients recover function in their neck, shoulders, lumbar spine, and pelvis.  For the fitness client, try putting two or three sets of  PUPPs between pulling exercises.  Watch the demonstrations and give the push up position plank a try.

View video here

Michael S. O’Hara, PT, OCS, CSCS

Nothing slows down your progress toward greater fitness and better performance than an injury. Bad combinations of exercises during a training session can set you up for a big crash. Poor exercise programming produces the joint overload or connective tissue stress that produces pain. Lumbar flexion activities combined with an exercise that compresses the lumbar spine is one of the more Hernaited_Disccommon killer combinations.

Here are some examples of lumbar flexion activities combined with exercise that increase lumbar intervertebral pressure. I am seeing these killer combos more frequently during my visits to the gym.

-Ten GHD sit ups followed by fifteen American Swings.

-Twenty medicine ball rotational crunches followed by a sixty yard farmers carry.

-Rowing machine for 500 meters followed by barbell on back walking lunges.

-Five toes to bar and then five barbell cleans.

-Five minutes of super slumped power texting followed by three heavy deadlifts.

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Activity GoalTRXfacepull1

Improve horizontal pulling strength. Enhance stability in the shoulders.


Strengthen the Deltoids, Traps, Rhomboids, Teres, Minor, and Bicep muscles. Improve neurological control that stabilizes the shoulder joint.

Starting Position

Grab a pair of TRX handles. Firmly grip the handles and lean back. Keep a straight line from your ear, shoulder, hips, knee and ankle.


Pull your hands toward your ears/face. As you pull, turn your wrist so that you finish with the back of your knuckles to your ears. You should finish with your elbows high, squeezing your shoulders together at the top.

Common Mistakes

Taking too steep of an angle; not rotating the wrist; lacking control; allowing hips to drop.

-Jeff Tirrell, B.S., CSCS